Periodontal Disease and Diabetes
It is well documented that people who suffer from diabetes are
more susceptible to developing infections than non-diabetes sufferers. It is
not widely known that t periodontal disease is often considered the sixth
complication of diabetes; particularly when the diabetes is not under proper
control.
Periodontal disease (often called periodontitis and gum
disease) is a progressive condition that often leads to tooth loss if treatment
is not promptly sought. Periodontal disease begins with a bacterial infection
in the gingival tissue which surrounds the teeth. As the bacteria colonize, the
gum pockets become deeper, the gums recede as tissue is destroyed and the
periodontitis eventually attacks the underlying bone tissue.
Diabetes is characterized by too much glucose (or sugar) in
the blood. Type II diabetics are unable to regulate insulin levels which means
excess glucose stays in the blood. Type I diabetics do not produce any insulin
at all. Diabetes is a serious condition which can lead to heart disease and
stroke.
Reasons for the Connection
Experts suggest the relationship between diabetes and
periodontal disease can worsen both conditions if either condition is not
properly controlled.
Here are ways in which diabetes and periodontal disease are
linked:
- Increased blood sugar
– Moderate and severe periodontal disease elevates sugar levels in the body,
increasing the amount of time the body has to function with high blood
sugar. This is why diabetics with periodontitis have difficulty keeping
control of their blood sugar. In addition, the higher sugar levels found in
the mouth of diabetics provide food for the very bacteria that worsen
periodontal infections.
- Blood vessel thickening
– The thickening of the blood vessels is one of the other major concerns for
diabetes sufferers. The blood vessels normally serve a vital function for
tissues by delivering nutrients and removing waste products. With diabetes,
the blood vessels become too thick for these exchanges to occur. This means
that harmful waste is left in the mouth and can weaken the resistance of gum
tissue, which can lead to infection and gum disease.
- Smoking
– Tobacco use does a great deal of damage in the oral region. Not only does
tobacco use slow the healing process, it also vastly increases the chances
of an individual developing periodontal disease. For diabetics who smoke,
the risk is exponentially greater. In fact, diabetic smokers aged 45 and
over are twenty times more likely to develop periodontal disease.
- Poor oral hygiene
– It is essential for diabetics to maintain excellent levels of oral
health. When daily brushing and flossing does not occur, the harmful oral
bacteria can ingest the excess sugar between the teeth and colonize more
freely below the gum line. This exacerbates the metabolic problems that
diabetes sufferers experience.
Diagnosis and Treatment
It is of paramount importance for people suffering from any
type of diabetes to see the dentist at least twice yearly for checkups and
professional cleanings. Studies have shown that simple non-surgical periodontal
treatments can lower the HbA1c (hemoglobin molecule blood test) count by as much
as 20% in a six month period.
The dentist will use medical history, family history and
dental X-rays to assess the risk factors for periodontal disease and determine
the exact condition of the gums, teeth and underlying jawbone. If necessary the
dentist will work in conjunction with other doctors to ensure that both the
diabetes and the gum disease are being managed and controlled as effectively as
possible.
Non-surgical procedures performed by the dentist and dental
hygienist include deep scaling, where calculus (tartar) will be removed from the
teeth above and below the gumline, and root planing, where the root of the tooth
is smoothed down to eliminate any remaining bacteria. Antibiotics may be
applied to the gum pockets to promote healing.
Before and after periodontal treatment, the dentist and
hygienist will recommend proper home care and oral maintenance as well as
prescribing prescription mouthwashes which serve to deter further bacteria
colonization.
If you have questions or concerns about diabetes or
periodontal disease, please ask your dentist.
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